ACA Blog

Apr 17, 2012

Sexual Assault and Rape in the Military: Are Survivors Being Treated Unethically?

According to StopMilitaryRape.org, a sexual assault or rape is reported as often as every four hours in the U.S. military. CNN’s Sanjay Gupta will feature a weekend report on sexual assault and rape allegations in the military. I was appalled (but not shocked) by what I read and heard in the online article, “Rape Victims Say Military Labels Them ‘Crazy.’” This article addresses the issue of how some survivors receive personality disorder diagnoses upon their report of a sexual assault or rape. I encourage you to read this article and to listen to the audio-recorded personal accounts of four military Service Women who experienced assault, rape, lack of support, and even a psychological diagnosis or military discharge: http://www.cnn.com/2012/04/14/health/military-sexual-assaults-personality-disorder/index.html?hpt=ju_t2

Unfortunately, I’m sure everyone is familiar with the presence of assault and rape within the U.S. military branches (and elsewhere in our society). You’ve probably also heard cases of how survivors are oftentimes mistreated by the military chain of command after the crime takes place. Sometimes a crime is “swept under the rug,” perpetrators are not held accountable whatsoever, and survivors face being called a liar or whore and may receive retaliation, punishment, or a lack of support or justice. However, what is NOT often discussed or scrutinized is the role of the military Behavioral Health Officer (psychological health care provider) once an assault or rape takes place.

The article I mentioned does just that. It addresses the military Behavioral Health Officer’s role in further exacerbating the effects of the trauma upon the survivor. Just as someone within the survivor’s chain of command can foster an environment conducive for predators, so can the unethical Behavioral Health Officer. Just as the unsupportive leader affects the survivor’s recovery from an incident, so does the unsupportive Behavioral Health Officer. In fact, it is sometimes the behavioral health care provider (which consists of every psychology-related profession EXCEPT licensed professional counselors and therapists, by the way—see my other blogs on that topic) who seals the fate for the Service Member who was assaulted or raped by ruining his/her career or making the traumatic experience worse.

Here are some direct quotes from the assault and rape survivors in the article (you can listen to their accounts by clicking on their photos):

“I met with the Coast Guard psychiatrist two times before he diagnosed me with Adjustment Disorder. The first time I met him he told me to ignore what my shipmate did to me because according to him, “Sailors will be Sailors.” The second time…he told me because I still talked about my rape [and it was two months later so I should be over it]…he recommended me for a [military] discharge for Adjustment Disorder.”

“I did receive counseling. I went in and at first…[my counselor] was really nice...but then it came up that I had been assaulted.”

“I had suspicions of [the Behavioral Health Officer’s] confidentiality. I didn’t tell him that he could say anything, so I was really surprised when the command came back and said they were discharging me for certain things. The only way they could have known that was from him.”

“...I’d been dealing with my chain of command for 7 months after reporting the sexual assault and it had been pretty traumatic. At one point…I tried to commit suicide. I overdosed on the anti-depression meds that they had me on.”

Other psychology-related quotes from the CNN article:

“One Navy lieutenant commander lost her pension and was involuntarily separated…[when] the Navy gave her a diagnosis of Adjustment Disorder after she reported being assaulted in the middle of the night in Afghanistan. She says no medical evaluation ever took place.”

“Rep Jackie Speier says the military has used personality and other psychiatric diagnoses “almost robotically” to force women who report sexual assaults out of the service.”

Former Marine company commander, Anu Bhagwati, has noticed a “pattern of the military using psychiatric diagnosis to get rid of women who report sexual assaults.”

“As for the personality and adjustment disorder discharges, the Pentagon tells CNN: “We encourage all separating Service Members who believe their discharges were incorrectly characterized or processed to request adjudication through their respective military department’s Discharge Review Board and Board for Correction of Military Records.”

What I see as the most common problem among military Behavioral Health Officers is the unethical lack of respect, regard, and client rights given to clients—especially the lower-ranking enlisted Troops. Confidentiality is a big issue—the BH Officer knows they are “allowed” to tell client matters to other people in the client’s chain of command so sometimes they do just that—without telling the client they are doing it! It is as if some officers know they can get away with doing/saying whatever they want about their client (which they almost always call “patient”) with no accountability. Diagnosing someone without telling them? Kicking them of the office with no explanation or referral? Speaking condescendingly to a client due to rank/position? Referring to themselves as “Counselors,” “Psychologists,” or “Doc” when in fact they are not that profession but are Social Workers? No discussion of treatment options other than “here’s a drug?” If they were in the civilian world, they could not get away with such things without facing the chance of losing their license.

Since some of you may be counselors who work with Service Members, I think it is important to consider what behavioral health care services, diagnoses, and medications the client may have received prior to showing up in your office. And if the client has a previous diagnosis or medication—don’t assume they are accurate! While this is always important, I can’t help but think there is a chance your military client may have experienced poor, brief, inaccurate, or “cookie-cutter” treatment if he/she has touched upon the military health care system.

While clearly there are many great, qualified Behavioral Health Officers in the military, it is important to also note the effects of the bad apples. Unfortunately, I’ve seen some of them first-hand who commit clear ethical violations and even instances where they backtrack and damage clients’ mental health. I bring this up to bring attention to the vital role of military Behavioral Health Officers to the welfare of Troops and especially survivors of crimes and to call for increased professional/ethical accountability. Military officers still must uphold ethical and professional standards and codes of their professions.

I also bring up this topic because oftentimes how a Service Member is treated while on a deployment (or in the service in general) can contribute to his or her “anger” or other behavioral issues. It is important to scratch beneath the surface of a routine assessment or session. Truly get to know each client and what they’ve experienced. It just might make all the difference in how you view a presenting issue or personality makeup—making you a more thorough and accurate professional.

References and Resources on this topic include:Sanjay Gupta reports for CNN on this topic this week, Saturday and Sunday, April 21 and 22 at 7:30 a.m. Eastern Time; April 14,2012 CNN article, “Rape victims say military labels them ‘crazy;’” Panayiota Bertzikis’s Military Rape Crisis Center; Bhagwati’s Service Women’s Action Network; Bertzikis’s blogs and websites, stopmilitaryrape.org and mydutytospeak.com; Military One Source phone number 800) 342-9647

Natosha Monroe is a counselor and PhD candidate passionate about increasing Troop access to counseling services. Her blog contents are not representative of the Army or Department of Defense in any way.